Insurance Representatives

Thank you for contacting Favored Medical Billing. Please use the HIPPA compliant/PHI Secure options below to complete your needs/requests.

Settlement Requests and Negotiations
Currently, the providers associated with Favored Medical Billing Do NOT Accept settlements/negotiations on outstanding claims unless the PAYMENT/CHECK AMOUNT is at 80% of the billed charge amount. For accounts that meet this criteria, ONLY email requests are accepted. Please email these request only to info@favoredmedicalbilling.com.


Information Request

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    W9


    Date of Request:
    Patient Name:
    Patient Date of Birth:
    Provider/Practice Name:
    Date of Service:
    Dates Needed (for Medical Records):
    Requestor Name:
    Requestor Email:
    Requestor Phone:
    Reference Number:
    Address to Mail Requested Information:
    Fax # to Send Requested Information:
    Please provide any additional information regarding your request.



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